Home Monitoring of High Blood Pressure
Parish Nursing
www.parishnursing.rlcw.org
Home Monitoring of High Blood Pressure
You may have what's called "white coat hypertension"; that means your blood pressure
goes up when you're at the doctor's office. Monitoring at home will help you measure
your true blood pressure and can provide your doctor with a log of blood pressure
measurements over time. This is helpful in diagnosing and preventing potential health problems.
What about equipment for home monitoring?
If your doctor or other healthcare provider has told you to monitor your blood
pressure at home, you'll need a sphygmomanometer. It has a cuff and a pressure
registering system. Some of them have a stethoscope. Some devices contain all of
these in one unit. There are three types: mercury, aneroid and automatic. Automatic
devices usually work with batteries and have a digital readout. They may remember and
even print out your readings. Each of the three types has advantages and disadvantages.
Mercury sphygmomanometer - This has always been regarded as the standard for blood
pressure measurement, but this is likely to change in the near future. The mercury
sphygmomanometer is durable, easy to read and doesn't require readjustment. It has a
simple mechanism and works by gravity to give consistent, accurate readings. It has a
long, tubular gauge made usually of plastic to prevent breakage. It's not often
recommended for home use due to the hazards of mercury.
Disadvantages include:
- May be bulky to carry.
- Mercury spills can be hazardous.
- Must be kept upright on a flat surface during measurement; the gauge must be read at eye level for accuracy.
- May not work well for the hearing or visually impaired or for those unable to perform
the hand movement needed to squeeze the bulb and inflate the cuff.
Aneroid equipment - This is often inexpensive, lightweight and more portable than
mercury sphygmomanometers. The aneroid gauge will work in any position if the
reader is able to view it directly. Some models have an easy-to-read, extra large
gauge; D-ring cuff for one-handed application; built-in or attached stethoscope;
and a self-bleeding deflation valve for increased reading accuracy.
Disadvantages include:
- Has a delicate and complicated mechanism.
- Less accurate than mercury sphygmomanometers and requires calibrating at least once a year or when dropped or bumped.
- Can be easily damaged without the user's knowledge and requires factory repair and readjustment.
- Gauge can be clumsy to position, and without a D-ring cuff can be difficult to apply by oneself.
- May not work well for the hearing or visually impaired or for those unable to perform the hand
movement needed to squeeze the bulb and inflate the cuff.
Automatic equipment - This is contained in one unit, so it's easier to handle than
systems with a separate gauge and stethoscope. It's easy to use, minimizes human
error and is good for people with hearing or vision loss. Most units are very portable
and have a D-ring cuff for one-handed application. The cuff may fit around the wrist or
arm. More expensive models have automatic inflation and deflation systems; large,
easy-to-read digital display and error indicator; reading printouts; and built-in pulse (heart rate) measurement.
Disadvantages include:
- Complex, fragile and sensitive mechanism.
- Must be checked for accuracy at regular intervals.
- Even the most accurate devices don't give accurate readings on certain people.
- Body movements may influence accuracy.
- Can be expensive, requires batteries and an AC adapter for large arm cuffs
and may require factory repair and readjustment when faulty.
- Requires careful cuff placement and arm positioning for accurate operation,
especially the wrist cuff model. (Some models are designed for use on only the right or left arm.)
- Large cuffs may be relatively expensive or difficult to obtain.
Do blood pressure cuffs come in different sizes?
Yes. Children and adults with smaller- or larger-than-average-sized arms may need
special-sized cuffs, available in some pharmacies and from medical supply companies.
You can also order them directly from companies that sell blood pressure cuffs.
Ask your doctor or pharmacist for help.
Talk to your healthcare professional about the kind of equipment you should use.
Take the equipment you've chosen to your healthcare professional. Ask that it be
tested for accuracy and learn how it works, how to use it, and what to do in case
of high blood pressure. Also find out where aneroid and automatic equipment can be
adjusted or "calibrated" by a trained technician. Remember that home blood pressure
measurement is not a substitute for periodic evaluation by your doctor or other health professionals.
Which monitor is right for you?
Monitoring your blood pressure with a digital monitor is convenient, easy to do and
takes less than a minute per measurement. Following is a features list for three
types of digital monitors:
Manual Inflation Monitors
- Easy to use and economically priced
- Clear, digital display panel
- Arm cuff is easy to apply
- Inflation bulb for quick inflation
Automatic Inflation Monitors With Fuzzy Logic
- Personalized cuff inflation and deflation
- Automatically adjusts to changes in your blood pressure
- Simple, one-button operation
- Clear, digital display panel
Wrist Monitors
- Measures blood pressure and pulse from the wrist
- Automatic cuff inflation and deflation
- Cuff wraps easily around wrist and can be used with obese people
- Compact design is convenient and portable
- Blood pressure measurements may not be as accurate as upper-arm monitors
- Systematic error can occur due to differences in the position of the wrist relative to the heart